State to reverse Medicaid cuts after outcry

The state of Kentucky says that it’s in the process of restoring benefits that thousands of adults on Medicaid lost after a federal judge’s ruling on the status of the Section 1115 Medicaid waiver known as Kentucky HEALTH.

The Cabinet for Health and Family Services (CHFS) released a statement Thursday evening acknowledging the decision to reverse the controversial cuts that followed U.S. District Judge James Boasberg’s June 29 decision on a lawsuit challenging the waiver.

The Cabinet also announced that the U.S. Centers for Medicare & Medicaid Services will hold a 30-day comment period on the Kentucky HEALTH program.

“In order to mitigate the consequences of the judge’s ruling, and avoid a prolonged coverage gap prior to the re-approval of Kentucky HEALTH, we have begun the process to reinstate vision and dental coverage, as well as nonemergency transportation services, for those whose benefits were affected by the June 29 court action,” the announcement states.

Consumer advocates, such as Kentucky Voices for Health and the Kentucky Equal Justice Center, hailed the development.

“This decision is a reminder that the voices of Kentuckians matter,” according to a statement from Kentucky Voices for Health, which had objected to the cuts and collected about 600 comments on the issue.

However, the group is reminding the public that coverage losses could still occur down the line. The federal public comment period will be open from July 19 through Aug. 18 and includes the waiver as well as its component parts, according to CMS.

“While this (CHFS) announcement comes as a sigh of relief for more than half a million Kentuckians who lost benefits without notice, the threat to Medicaid coverage is not over,” Kentucky Voices for Health notes.

“Late today,” it continued, “CMS opened a new Federal comment period in an attempt to re-approve the very same requirements and penalties proposed in the Governor’s 1115 Medicaid waiver that was recently blocked in federal court. Kentucky Voices for Health will again be collecting comments with the hope that state and federal administrators will listen closely to the needs and concerns of Kentuckians and work collaboratively with stakeholders to design a waiver that will truly move Kentucky’s health, economy and quality of life forward.”

The waiver, which would have taken effect July 1, was challenged in federal court by more than a dozen Medicaid beneficiaries who disputed the legality of the Trump administration’s approval of the waiver and said it would lead to scores of people losing coverage. The program’s features included work or “community engagement” requirements as well as premiums and lockouts.

Boasberg kicked the program back to the U.S. Department of Health and Human Services for further review, saying, the Trump administration had “never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

However, instead of keeping benefits as they had been before the ruling for Medicaid expansion adults, Gov. Matt Bevin’s administration discontinued the dental, vision and nonemergency medical transportation, triggering confusion around the state.

Congressman John Yarmuth and other Democrats criticized the Bevin administration for stripping dental and vision benefits from certain Medicaid recipients. | Photo by Joe Sonka

An outcry erupted from several justice groups and health care providers as well as many state lawmakers and Congressman John Yarmuth.

Initially, the state said there was no legal authority to pay for the services that got cut after Boasberg’s ruling. It cited the inability to put into place a feature called My Rewards that would have allowed eligible Medicaid recipients to earn virtual dollars for things like routine dental and vision care.

The Cabinet notes in its Thursday statement that “changing benefits and coverage is not as easy as flipping a single switch.”

“As Cabinet officials testified, system changes are risky and cannot be made overnight,” it said. “The Cabinet has spent the last few weeks working on a temporary solution for restored benefits to be implemented by August 1. In addition, while dental, vision, and nonemergency medical transportation eligibility for those in the Alternative Benefit Plan will not show in the system until August 1, the Cabinet is close to completing a manual system workaround that will allow payment of claims incurred by any eligible Medicaid beneficiary for dental, vision, and nonemergency transportation services incurred during the month of July.”

Cara Stewart, a health law fellow for the Kentucky Equal Justice Center, expressed joy over news of the reversal. The center was among a group of justice organizations that recently wrote to CMS challenging Kentucky’s authority to make the dental, vision and nonemergency medical transportation cuts.

“I’m thrilled for all the Kentuckians, patients and providers, who have reached out to me ranging from desperate and scared to just confused,” Stewart said. She also noted “cancer patients who were turned away from dental treatment they needed to protect and restore their mouth from cancer treatments.”

State House Democratic Leader Rocky Adkins released a statement on behalf of the House Democratic Caucus, which had recently sent a letter to the secretary of the Cabinet for Health and Family Services, asking for answers about the Medicaid cuts.

“Our caucus stood loud and firm on this issue, because the decision early this month to take away those services with no advance warning created an immediate hardship for those directly affected and caused needless headaches for numerous health care providers,” the statement said. “The governor and his administration were wrong to blame this cruel action on the federal court ruling that blocked this waiver, but I’m glad they appear to be back on the right track. I’m hopeful that our citizens will not be faced with the devastation of losing these benefits again.”